Benign upper extremity tumors: factors associated with operative treatment.

BACKGROUND: Tumors are common in the upper extremity and are mostly benign and inconsequential. The purpose of this study was to determine factors associated with operative treatment for suspected benign tumors of the upper extremity.

METHODS: Treated by three different hand surgeons between July 2001 and July 2011, 1,593 tumors were identified using billing records. The measured variables were: sex, age, marital status, pain, neurovascular status, location of the tumor, bilateral involvement, preoperative diagnosis, prior surgeries in general, prior aesthetic surgery, prior tumor surgery in general, prior upper extremity tumors, prior upper extremity tumor surgery, prior surgery for same tumor, current or prior cancer, and number of visits before treatment. Variables associated with operative treatment were assessed in bivariate analysis and backwards elimination logistic regression analysis.

RESULTS: Factors that significantly increased the probability of surgery were a higher number of visits before treatment, giant cell tumors, treated by surgeon A, lipomas, tumors located on the finger, and prior upper extremity tumors. Factors that significantly decreased the probability of surgery were treated by surgeon B and retinacular/tendon sheath ganglion cysts. Prior or current cancer was not significantly associated with operative treatment.

CONCLUSIONS: Tumor location, preoperative diagnosis, prior upper extremity tumor, and surgeon affect the likelihood of surgery for an upper extremity tumor.

LEVEL OF EVIDENCE: Prognostic II.